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PostPosted: Sat Feb 02, 2013 10:51 am 
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I'm new here. I don't take suboxone or subutex, but I do take methadone 30MG/day.
I have a son with autism and its hard, hard work. I have another son with ADHD, so that makes for even longer days! Anyway, I had bronchitis back in November. I don't know if anyone else has had it ever, but it hurts! Being pregnant with bronchitis is even worse....Every cough made me almost double over, plus I peed every time I coughed (funny looking back, not funny at the time!). Anyway, I was given amoxicillan and that's it. I took it, but was still sick for over a month. Before when I've had it I've been given Robitussijn with codiene, which suppresses coughs. My primary Dr was scared to give me anything, so I just had plain old robitussin. I was in so much pain and started getting depressed, felt overwhelmed being sick and taking care of the boys. I had a 2MG Dialudid and I took it. I didn't feel better taking it of course. The methadone blocked the effects, which I knew but didn't know, since I had never taken anything since starting methadone in 2009. I've never had a dirty urine, except for when I started methadone of course.
So now I'm paranoid about losing my kids because of that screw up. I know mecoinium is tested and I'm hoping that the one I took doesn't show up, but I'm not sure. My OB knows about the methadone, as does the hospital. I've been honest with them about everything as far as methadone goes. I plan on using an IV for pain control during labor, no epidural, but not natural, either. I'm so, so scared. I plan on admitting what I did, being as honest as possible and hoping it doesn't bite me in the butt, but I'm scared. Any words of advice or experience with a similar situation are appreciated and needed.


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PostPosted: Sat Feb 02, 2013 9:26 pm 
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Sounds like you've got your hands full! I hope you have a good husband who helps you with your children and who'll help with the new baby as well. It's difficult taking care of kids, especially when there are special needs involved. Even with two involved parents, other family/friends support is usually necessary...at least if Mommy is to have any hope at all of having herself taken care of too! We moms tend to forget or very much underemphasize the importance of taking care of ourselves, don't we?
Anyway, good for you for doing your best to be honest and be on a maintenance program during your pregnancy! Other than complete sobriety, which isn't possible for everyone, it's the best you can do for your baby. I hope he/she will do very well and your birth plan will go as you wish as well.
You mentioned wanting to go with no epidural, just IV pain medications, if I understood you correctly. Unless your methadone dose is pretty low, will you get much relief from the standard IV pain meds normally given for childbirth? Generally, the meds given IV for the discomfort of labor are not given in very high doses in an effort to prevent respiratory depression in the newborn. Plus, if you're an opiate addict, the feeling you might get from IV narcotics might be sort of a trigger for you....although I do think the likelihood of that is fairly low given that you will be in a painful situation. Although I am all for natural childbirth personally, I'm just thinking that an epidural might be a better alternative in your case. You'd almost certainly have excellent pain relief and could avoid opioids altogether. Just a thought.
As for the lapse you had a few months ago. I wouldn't worry too much. They probably will test the meconium because of your history. But as I understand drug testing, there are always cut off levels...there has to be enough of a substance or its metabolite to register a positive result. I'm thinking that only the one dose of an illicit substance over a period of many weeks will not be enough to cause a positive. I do not know for sure though, so take it for what it's worth. I think you'll be okay. You'll probably get a visit from social services regardless, because of the methadone. As long as your providers know and you have a legit Rx, they'll probably just briefly interview and assess and that'll be it.
Please forgive yourself and don't let guilt drive you to pick up again,,,ever. Your babies deserve a sober mom and you deserve it too. Please come back and let us know what happens.


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PostPosted: Sat Feb 02, 2013 10:33 pm 
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I do have a good husband, thank goodness! My in-laws also take my boys overnight once a week, which I wouldn't survive without.
I have done research on the IV meds, and I know that Nubain and Stadol can send me into withdrawals. The other options are morphine and fentanyl. I can't be denied because of methadone hopefully. I plan on taking my research to my OB in two days at my appointment. As for the screw up I did, it really was the one time and I felt guilty as hell! It also, though, felt good to know that I didn't feel high, you know? The methadone works. Actually, I was wondering about some things I've read on here. Why are so many against mmethadone? Is it just a personal choice? It saved my life, as I know subutex and suboxone saved all those who use that. Just wondering, not trying to debate at all. I had never even heard of subutex or suboxone until about 6 months ago! I heard it is cheaper. I pay $80/week, is that high compared to the others?


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PostPosted: Sun Feb 03, 2013 12:41 am 
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Glad to hear you have good support!
You should receive nothing but support here for using methadone as your maintenance choice. This forum is for recovery first and foremost. The doctor who started the site just happens to be a proponent of bupe for reasons you can find on his blog. Most of us here lean towards bupe, I think, for a few reasons....it can be written for in a physician office environment in quantities to cover up to a month supply, sometimes with refills, thereby avoiding the whole clinic setting, daily supervised dosing, etc that methadone usually requires. Bupe is a partial opiate agonist as opposed to a full agonist like methadone, allowing it to have a different or less labeling or scheduling class as far as controlled substances go. Bupe is generally agreed to have a bit of an easier and higher likliehood of taper or withdrawal, although that's debatable depending on who you ask. Methadone is typically thought of to have a higher abuse and diversion potential, while bupe is thought of to have less so due to its "ceiling effect" which almost makes overdose impossible. That's just a few things I've ascertained through my own readings, etc.
As for its use in pregnancy, depending partly on what part of the world or the US you're from, methadone is still considered to be the standard of care for maintaining pregnant women...if for no other reason than that is what the literature says. There's just not enough respected, scientific studies yet to show that bupe is probably a better choice as I believe the risk of NAS will eventually prove to be lower with bupe. But that is purely speculation on my part, I'll freely admit! I also believe its got to be at least somewhat dose dependent...the lower the dose of either drug, the lesser the likelihood of NAS.
In either case....both are preferable over active addiction during pregnancy. Surely everyone would agree on that, right?!
I'm impressed...you know not to let anyone come near you with Stadol or Nubain....good job!! I've never seen morphine ordered for labor, but I have seen Fentanyl ...caveat being its usually not going to exceed 100-200 mcg. Again, depending on how much methadone you're on, that dose of fent may not help much. Hopefully, this being your third...labor will go fast and you can utilize other nonmedical pain control techniques to get by. If you can possibly avoid being induced, the odds of a faster, "easier" labor will be in your favor.
These are just my opinions, of course. If you'd like, you can PM me if you'd like more info.
Thanks for replying back.


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PostPosted: Sun Feb 03, 2013 3:25 am 
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Congrats on your soon to be new baby.. I just wanted to say a few things related to your post.
I am on subutex, I started out on suboxone but when I got pregnant with my now 8 month old daughter I was switched but I feel so much better on subutex that I didnt switch back. I started out at 8mg a day but by the end of my pregnancy was up to 24mg daily due to my blood volume increasing. My doctor (luckily) specializes in sub and pregnancy, I was very nervous taking this med and being pregnant but she assured me everything would be fine and she was right, my daughter was NAS free, happy and healthy. I did talk with her alot though because as I said I was nervous about the meds and even thought about switching at one point to methadone because I had heard thats the better route but my doctor told me no way.. she said with methadone you are almost guaranteed to have a baby born with NAS and with sub there is only a very small chance that the baby will have withdrawals, which now I know is true because 90% of the birth stories I read pertaining to sub use during pregnancy are good, babies with no withdrawals. My doctor also told me with sub it doesnt matter how much sub you take during pregnancy, your dose is irrelevant when it comes to NAS.. there has been babies born with NAS with their mother on 1mg and babies born without NAS to mothers on 32mg. I just wanted to point that out because I do hear many pregnant women talk about weening down to reduce the risk of NAS but thats just not how it works. I had a natural childbirth, the hospital I went to wouldnt give me pain meds.. #1 because I was addicted to them at one point and they still considered sub as me being dependent on an opiate so they just wouldnt give me something I was addicted to and #2 because they told me my sub would block any meds from working anyway.. I asked them about just giving me higher doses to over-ride the sub like I have read on this forum before but they told me the only time thats done is when pain meds are absolutely needed (ie-car accident) they told me labor is not a good reason to dope someone up on extreme doses of pain meds especially when it can hurt the baby. The hospital made me speak to a social worker while I was there, I never had one come to my home but they did test the babys maconium, they told me that they could find out any drug ive even touched during pregnancy by doing that test, I guess somehow if you touch cocaine your fingers will absorb it into your body or something, I dont know but they told me they could tell if I had even done that during my pregnancy.. maybe they were just saying that to try to scare me.. I wasnt treated the best because of sub there but I wasnt treated really bad either. Well if you have any questions, feel free to ask otherwise good luck and I wish you a safe labor and delivery. :)


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PostPosted: Sun Feb 03, 2013 7:31 am 
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BeautifulMess.......Sounds like your hospital is not very educated on the medicine you take! Although all things I read are related to methadone, I assume the same applies to Subs..... We still need help as laboring women, and should receive it if needed. Kudos for going natural, I did it once, and that was more than enough for me! "You forget all about the pain".. I have heard that so many times, but I haven't forgotten, and I never will. Your story confirms my thoughts that I need as much literature as I can print to take with me! I am lucky that my clinic has had three patients deliver babies at my hospital in the last two months. I have fetal stress tests 2x a week, and the nurse told me they automatically keep methadone babies for 4 days to watch for NAS. I hope she doesn't need treatment, but if she does at least she will be in good hands.
As for meconium testing, I know they will test and I know they will find out what I did. I'm hoping my one mistake won't overshadow my parenting. Also, I believe CPS SHOULD be involved in aftercare. I am an addict, always will be, all of us are. I've decided that I will refuse any script my OB gives me for after delivery. I think Advil will have to be enough!
Y'all are incredibly nice on here. Nothing I hate more than going on sites like baby gaga or what to expect and seeing the bashing people take. As though I decided to be addicted, right? No one has childhood dreams of being high everyday. The people who bash are possibly just feeling guilt over something they've done.
Anyway, thank you both, you have been helpful and encouraging! I plan on posting a lot more a lot more. Please wish me luck!


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PostPosted: Sun Feb 03, 2013 2:19 pm 
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I did just a few minutes of Internet research and came across a pretty excellent link for you. You may have already seen it. If so...great! If not, maybe a moderator could post it as a "sticky" at the top of this pregnancy section for others to easily find it.
What made me happy to find this is that it's new!...from May of 2012! And the last time I searched for anything like this, there was hardly any literature about bupe and pregnancy....and it's from ACOG!

http://www.acog.org/Resources_And_Publi ... _Pregnancy

The article confirms the drugs to avoid which may precipitate withdrawal...Stadol, Nubain, Talwin and it suggests that pain medications should be titrated up to about a 50% increase from the usual standard dosages. Personally, I think that's a conservative estimate...I'd lean more towards a double dose! The other thing it reminded me to tell you was to ask for Toradol (ketorolac) postpartum.

I was curious about what was said about the need for going up to 24mg a day of bupe because bupe is known to have a ceiling effect which made it seem to me that dose increases wouldn't be necessary. The article did suggest that with methadone, dosage increases are often necessary due to the blood volume increase with pregnancy. But with bupe, I think it was suggested to go to split dosing rather than dose increase. I'm not disputing what Beautifulmess did...obviously she was following her doctor's order and everything went great for her baby. I'm just mentioning it in an effort to provide information for future readers who might make the assumption that because they are pregnant, they need to up their bupe dose, even well over the usual standard maximum dose of 16mg a day (I think that's still the standard, anyway.).

Disclaimer...I did not study the article, just read through it, so if I've misstated anything, I apologize and please correct me. I'm not a doctor or an expert, so my opinions are just that. That's why I love it when we can find articles, especially professional ones, to help us sort opinions and personal experience from expert studies, findings and conclusions.

Unfortunately, I did not find a lot of info about the meconium testing except that I was wrong about there being a cutoff level. There is no cutoff with mec testing because there should be no illicit substances there. However, there is a minimal level that has to be there for detection...and I still think/hope that maybe there's a chance your one slip up won't be detected.

I hope the article helps. Maybe you can print it and give a copy to your OB and one to the RN upon your admission to L & D. Jennifer, please keep your mind open to the epidural for labor...especially if you have to be induced or if your labors tend to be lengthy. I don't want you to have more pain than you can or want to handle.


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